COVID-19 y rinosinusitis invasiva aguda secundaria a mucormicosis: a propósito de 2 casos en Colombia / Covid-19 and acute invasive rhinosinusitis secondary to mucormycosis: report of two cases in Colombia

Introducción: la mucormicosis es una infección micótica poco frecuente, también conocida como zigomicosis o phycomycosis, de baja prevalencia, pero con alta mortalidad, por lo regular ocasionada por estados de inmunosupresión como los que ocurren después de infecciones por COVID-19, teniendo esta asociación patológica una alta tasa de mortalidad y secuelas en la salud de los que la padecen. Presentación de los casos: son dos casos de mucormicosis rinocerebral asociados con COVID-19 y se describen el manejo y los desenlaces.

Introduction:mucormycosis is a rare fungal infection, also known as zygomycosis or phycomycosis. It features low prevalence and high mortality rate. It usually affects patients with altered immunity precipitated by COVID-19 infection. This co-infection is associated with high mortality rate and sequelae in affected patients. Case report: we present two cases of rhino-cerebral mucormycosis co-infection in COVID-19 patients, the provided treatment, and outcomes.

Zigomicosis y síndrome hemofagocítico en un paciente inmunocompetente: informe de caso / Zygomycosis and hemophagocytic lymphohistiocytosis in an immunocompetent patient: a case report

Introducción: la zigomicosis es una infección fúngica poco frecuente, con alta tasa de mortalidad y de mal pronóstico. Afecta principalmente a pacientes inmunocomprometidos. La asociación con el síndrome hemofagocítico es extremadamente inusual, más aún en pacientes inmunocompetentes, con pocos ejemplos registrados en la literatura. Caso clínico: se presenta el caso de un paciente masculino inmunocompetente de 40 años con diagnóstico de mucormicosis y síndrome hemofagocítico que evoluciona desfavorablemente, con fallo multiorgánico, a pesar de los esfuerzos médicos. Conclusión: la asociación de mucormicosis con síndrome hemofagocítico en un paciente inmunocompetente es extremadamente rara; existen pocos casos informados en Latinoamérica. Debemos tener presente esta asociación, ya que requiere un tratamiento agresivo y soporte vital avanzado. (AU)

Introduction: zygomycosis is a rare fungal infection that carries with high mortality rates. This poor prognosis, rapidly progressive infection mainly affects immunocompromised patients. The association with hemophagocytic lymphohistiocytosis is extremely unusual, even more in immunocompetent patients, with few cases reported. Case: we present the case of an immunocompetent male patient who was diagnosed with zygomycosis and hemophagocytic lymphohistiocytosis. Despite medical efforts he developed multiorganic failure. Conclusion: the association of mucormycosis with hemophagocytic lymphohistiocytosis in an immunocompetent patient is exceptional with few cases reported in Latin America. We must always suspect this association considering they require aggressive treatment and advanced life support. (AU)

Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review

Abstract Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence.

Proteínas imunorreativas de Conidiobolus lamprauges isoladas de ovinos infectados naturalmente / Immunoreactive proteins of Conidiobolus lamprauges isolated from naturally infected sheep

O estudo de conidiobolomicose ovina tem sido realizado nos seus aspectos clínicos, epidemiológicos, patológicos e moleculares. Informações, entretanto, sobre a resposta imune do hospedeiro na infecção por Conidiobolus lamprauges são inexistentes. Este estudo teve por objetivo a identificação de proteínas imunorreativas que possam desempenhar papel importante na resposta imune de ovinos naturalmente infectados por C. lamprauges. Para a caracterização protéica e imunológica foi utilizada a cepa de C. lamprauges (FIOCRUZ-INCQS 40316) isolada de ovino com sinais clínicos de conidiobolomicose no Estado do MT e cinco amostras de soro de ovinos infectados naturalmente pelo fungo. A presença de anticorpos IgG foi observada em todos os animais doentes com títulos reagentes em diluições de até 1:1.600. Na técnica do immunoblot, o perfil antigênico frente aos soros ovinos com a doença apresentou doze bandas reativas, com massas moleculares variando de 35 a 198 kDa. Dentre estas, a proteína de 198 kDa foi reativa em 3 soros de ovinos e a de 53 kDa apresentou a maior intensidade comparativamente com outras bandas, sendo provavelmente imunodominante. Amostras de soro de animais sadios não apresentaram reatividade demostrando a especificidade da técnica. A presença de proteínas antigênicas de C. lamprauges e IgG específicos em soros de ovinos observados no presente trabalho poderá auxiliar no desenvolvimento de métodos de diagnóstico precoces e na utilização de proteínas candidatas a vacinas para o controle e prevenção da infecção em animais e humanos.(AU)

The study of sheep conidiobolomycosis has been carried out in its clinical, epidemiological, pathological and molecular aspects. Information, however, about the host immune response in infection Conidiobolus lamprauges is absent. This study aimed to identify immunoreactive proteins that may play an important role in the immune response of sheep naturally infected by C. lamprauges. For protein and immunological characterization, C. lamprauges (strain FIOCRUZ-INCQS 40316) isolated from a sheep with clinical signs of conidiobolomycosis in the MT state and five sera samples of naturally infected sheep were used. The presence of IgG antibody was observed in all patients with reagent titers in dilutions up to 1:1600. In immunoblot technique, the antigenic profile against infected sheep sera showed twelve reactive bands with molecular weights ranging from 35 to 198 kDa. Among them, the 198 kDa protein was reactive against sera from three sheep and the 53 kDa showed increased intensity compared to other bands probably being immunodominant. Healthy animal serum samples showed no reactivity demonstrating the specificity of the technique. The presence of antigenic proteins of C. lamprauges and specific IgG in sheep sera observed in this study may assist in the development of early diagnostic methods and the use of protein as candidate vaccines for the control and prevention of infection in animals and human.(AU)

Trombosis de seno cavernoso causada por zigomicosis invasiva fulminante: A propósito de un caso / Cavernous sinus Thrombosis caused by fulminant invasive zygomycosis: A case report

Zygomycosis is an opportunistic fungal infection caused by fungi of the Mucorales order. It’s potentially lethal infection which generally affects diabetic or inmunocomprised patients. Cavernous sinus thrombosis is uncommon complication. We report the case of a 67 year old woman with invasive zycomycosis who present cranial nerves dysfunction (III, IV, VI, V1 and V2 branches of the trigeminal nerve), proptosis and retroorbital pain as initial manifestation. Brain magnetic resonance imaging evidence early indirect signs. Biopsy of the cavernous sinus revealed Rhizopus as the offending agent. A high index of suspicion is needed to correctly diagnose this condition for its optimal management.

La zigomicosis es una infección oportunista y potencialmente letal producida por hongos del orden Mucorales. Afecta a pacientes diabéticos e inmunocomprometidos. La trombosis del seno cavernoso es una complicación poco frecuente. Presentamos el caso de una paciente mujer de 67 años diagnosticada de zigomicosis invasiva que debutó con compromiso de pares craneales (III, IV, VI además de las ramas V1 y V2 del nervio trigémino), proptosis y dolor retroorbitario derecho. La resonancia magnética craneal, en fase aguda, mostró signos indirectos característicos. La biopsia de seno cavernoso confirmó la presencia de Rhizopus. Se precisa un alto índice de sospecha clínica que favorezca una intervención terapéutica precoz y agresiva.

Zigomicose rino facial: relato de caso / Rhino facial zygomycosis: case report

A zigomicose é uma doença invasiva, que acomete tanto imunocompetentes como imunocomprometidos, dependendo do tipo da cepa. O diagnóstico é clínico e histopatológico, e o tratamento é baseado em antifúngico e em limpeza cirúrgica. O presente relato de caso é sobre um menino com zigomicose rinofacial invasiva com tratamento final bem-sucedido, após terapias antifúngicas e limpezas cirúrgicas.

Zygomycosis is an invasive disease that affects both immunocompetent and immunocompromised, depending on the type of strain. This disease diagnosis is clinical and histopathological, and its treatment is based on antifungal therapy and surgical cleaning. This paper reports a case of a boy with invasive zygomycosis rinofacial who final treatment was successful after underwent antifungal and surgical therapies.

Utilização de três métodos imuno-histoquímicos na detecção de aspergilose e zigomicose em animais / Usage of three immunohistochemical methods in the detection of aspergillosis and zygomycosis in animals

Visando a otimização do uso da técnica de imuno-histoquímica (IHQ) na detecção de Aspergillus spp. e zigomicetos (membros da família Mucoraceae), utilizaram-se dois anticorpos monoclonais fungo-específicos em fragmentos de tecidos de animais (fixados em formol e embebidos em parafina) com diagnóstico histomorfológico prévio de aspergilose e zigomicose, os quais foram submetidos a três sistemas de detecção diferentes (dois biotinilados e um não biotinilado). Os dois anticorpos apresentaram alta especificidade e sensibilidade nos tecidos examinados. Não ocorreram reações cruzadas entre os anticorpos utilizados e os agentes etiológicos avaliados (incluindo casos de aspergilose, zigomicose, candidíase e pitiose). No entanto, reações inespecíficas foram observadas nas hifas em alguns casos, as quais puderam ser eliminadas através de um dos métodos de detecção utilizados. Para a aspergilose, o método da estreptavidina-biotina-fosfatase alcalina não apresentou reações inespecíficas nas hifas. Enquanto que nos casos de zigomicoses, as reações inespecíficas não ocorreram no método por polímero (não biotinilado). A técnica de IHQ mostrou-se uma ferramenta muito útil na detecção e confirmação dos casos de aspergilose e zigomicose neste estudo retrospectivo.

Aiming to optimize the usage of the immunohistochemical technique (IHC) in the detection of Aspergillus spp. and zygomycetes (members of the Mucoraceae family), two fungal-specific monoclonal antibodies were used in tissue fragments (formalin-fixed paraffin-embedded), previously diagnosed by histomorphology as aspergillosis and zygomycosis. Tissues were submitted to three different detection systems (two biotinilated and one non biotinilated). Both antibodies showed high specificity and sensitivity in the examined tissues. No cross-reactions were observed between the antibodies used and the agents evaluated (including cases of aspergillosis, zygomycosis, candidiasis and pythiosis). However, nonspecific reactions in hyphae were observed in some cases, but were eliminated by mean of one of the detection systems used. In the aspergillosis cases, with the streptavidin-biotin-alkaline phosphatase method, nonspecific reactions were not observed. In the zygomycosis cases, nonspecific reactions did not occur using a polymer (nonbiotinilated). The IHC technique showed to be a useful tool detecting and confirming aspergillosis and zygomycosis in this retrospective study.

Ocorrência de micoses e pitiose em animais domésticos: 230 casos / Occurrence of mycoses and pythiosis in domestic animals: 230 cases

A retrospective study was performed to determine the main mycoses and oomycosis that affected domestic animals diagnosed in the Laboratório de Patologia Veterinária (LPV) of the Universidade Federal de Santa Maria (UFSM). A total of 29,686 exams (9,487 necropsy reports and 20,199 biopsy reports) performed between January 1990 and December 2012 were analyzed. Two hundred and thirty cases (78% of mycoses and 22% of pythiosis) were found. Data about epidemiology, clinical signs, gross and histologic lesions were obtained from the reports. In two cases the fungi observed were not identified. The main diseases observed, in descending order of prevalence, were: pythiosis, candidiasis, aspergillosis, zygomycosis, dermatophytosis, mallasseziosis, cryptococcosis, megabacteriosis, and sporothrichosis. Others diseases with only one cases each were histoplasmosis and pneumocystosis. Pythiosis affected mainly horses and the mycosis affected mainly companion animals (dogs and cats).

Para determinar as principais micoses e oomicoses que acometeram animais domésticos na área de abrangência do Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), foi realizado um estudo retrospectivo em 9.487 protocolos de necropsias e 20.199 exames histopatológicos (totalizando 29.686 casos), realizados no LPV-UFSM, entre janeiro de 1990 e dezembro de 2012. Do total de protocolos analisados, 230 apresentaram micoses ou pitiose (oomicose), sendo 179 casos (78%) de micoses e 51 casos (22%) de pitiose. Os protocolos foram revisados para determinar os principais achados referentes à epidemiologia, sinais clínicos e às alterações macroscópicas e microscópicas. Em dois casos (0,8%) não foi possível determinar o gênero ou o grupo do fungo observado. As principais doenças diagnosticadas, em ordem decrescente de prevalência, foram: pitiose, candidíase, aspergilose, zigomicose, dermatofitose, malasseziose, criptococose, megabacteriose e esporotricose. Outras doenças diagnosticadas numa única ocorrência cada foram histoplasmose e pneumocistose. Os equinos foram os mais acometidos pela pitiose e os animais de companhia (cães e gatos) foram os mais acometidos pelas micoses.

Development and application of polymerase chain reaction test for detection of Conidiobolus lamprauges / Desenvolvimento e aplicação da reação em cadeia da polimerase para detecção de Conidiobolus lamprauges

Conidiobolomycosis is a granulomatous disease caused by the fungus Conidiobolus spp. in humans and animals. Traditional technique for diagnosis of the disease is isolation of the agent associated with the presence of typical clinical signs and pathological conditions. The aim of this study was to describe the development of a specific polymerase chain reaction (PCR) test for Conidiobolus lamprauges to detect the fungus in clinical samples. Samples from suspected animals were collected and submitted to isolation, histopathological analysis and amplification by PCR. DNA from tissues was subjected to PCR with fungi universal primers 18S rDNA gene, and specific primers were designed based on the same gene in C. lamprauges that generated products of about 540 bp and 222 bp respectively. The culture was positive in 26.6% of clinical samples. The PCR technique for C. lamprauges showed amplification of DNA from fresh tissues (80%) and paraffin sections (44.4%). In conclusion, the PCR technique described here demonstrated a high sensitivity and specificity for detection of fungal DNA in tissue samples, providing a tool for the rapid diagnosis of C. lamprauges.

A conidiobolomicose é uma doença granulomatosa causada pelo fungo Conidiobolus spp., observada em humanos e animais. As técnicas tradicionais de diagnóstico da doença são o isolamento do agente associado à presença de sinais clínicos típicos e condições patológicas. O objetivo deste trabalho é descrever o desenvolvimento de um teste da reação em cadeia da polimerase (PCR) específico para Conidiobolus lamprauges em amostras clínicas. As amostras de animais suspeitos foram coletadas e submetidas ao isolamento, análise histopatológica e amplificação pela PCR. O DNA de tecidos foi submetido a PCR com os iniciadores universais de fungos baseados no gene 18S rDNA e iniciadores específicos foram concebidos com base no mesmo gene em C. lamprauges que gerou produtos de aproximadamente 540 pb e 222 pb, respectivamente. A cultura foi positiva em 26,6% das amostras clínicas. A técnica de PCR para C. lamprauges mostrou a amplificação de DNA a partir de tecidos frescos (80%) e secções de parafina (44,4%). Em conclusão, a técnica de PCR aqui descrita demonstrou elevada sensibilidade e especificidade na detecção de DNA de fungos em amostras de tecido, proporcionando uma ferramenta rápida para o diagnóstico de C. lamprauges.

Rhinocerebral zygomycosis in a diabetic patient / Zigomicose rinocerebral em paciente diabética

Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

Zigomicose rinocerebral é a forma mais frequente das infecções fúngicas causadas por membros da classe Zygomicetes. É relatado um caso fatal de zigomicose rinocerebral por Rhizopus (oryzae) arrhizus com diagnóstico histopatológico e micológico, em paciente diabética.

Zigomicosis / Zygomycosis

Las zigomicosis son infecciones fúngicas graves e inusuales, causadas por hongos ubicuos pertenecientes a la clase Zigomicetos, los cuales están subdivididos en dos órdenes: Mucorales y Entomoftorales. Las infecciones causadas por los Mucorales se caracterizan por su rápida evolución, con destrucción tisular e invasión de vasos sanguíneos. Se presentan en hospederos con factores de riesgo definidos, entre los que se incluyen alteraciones funcionales o cuantitativas de los neutrófilos, acidosis metabólica o aumento en los niveles séricos de hierro. Sus manifestaciones clínicas se dividen en rinocerebral, pulmonar, cutánea, gastrointestinal y diseminada. El principal mecanismo de infección es la vía inhalatoria, seguida por la mecánica por lesiones dérmicas. Tienen un curso clínico agresivo y a su vez inespecífico que usualmente pone en peligro la vida del paciente, por lo que se debe tener un alto índice de sospecha en aquellas personas con cuadro clínico sugestivo y factores de riesgo, para iniciar tratamiento agresivo temprano con antifúngicos y cirugía.

Zygomycosis are severe and uncommon fungal infections caused by ubiquitous fungi members of the class zygomicetes, which are subdivided into two orders: Mucorales and Entomophtorales. Infections due to Mucorales are characterized by a rapid evolution along with a wide tissue destruction and direct invasion of blood vessels. These diseases are seen in individuals with clearly defined risk factors such as quantitative or qualitative neutrophil defects, metabolic acidosis, or elevated iron serum levels. The clinical forms of these diseases are divided into new categories: Rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated infections. The main mechanism of infection is by inhalation, but it is also possible to acquire the infection by direct inoculation into the dermis. The clinical course is aggressive but unspecified and usually threatens patients' survival; therefore, we must have a high index of suspicion in those cases with a suggestive clinical scenario and risk factors in order to perform a timely and aggressive intervention with antifungal therapy and surgery.

Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment

Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39°C) lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus). Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.

Conidiobolomicose causada por conidiobolus lamprauges em ovinos no estado de Santa Catarina / Conidiobolomycosis caused by conidiobolus lamprauges in sheep in the state of Santa Catarina, Brazil

Descreve-se um surto de conidiobolomicose em ovinos no Estado de Santa Catarina. O surto ocorreu entre os meses de dezembro e março de 2006, no município de Santo Amaro da Imperatriz, região litorânea do Estado. A propriedade possuía 75 ovinos da raça Santa Inês e seis desses animais adoeceram. Clinicamente os animais doentes apresentavam dificuldade respiratória, corrimento nasal seroso a mucossanguinolento e, por vezes exolftalmia. Na necropsia verificou-se uma massa amarelada na região etmoidal e adjacências que, às vezes, atingia os linfonodos regionais, cérebro, globo ocular e pleura. Microscopicamente a massa caracterizava-se por infiltrado inflamatório granulomatoso com áreas necróticas associadas a hifas largas pouco ramificadas. Através de exame molecular detectou-se DNA de Conidiobolus lamprauges. Os aspectos clínicos, epidemiológicos, macroscópicos, microscópicos e moleculares caracterizam a conidiobolomicose causada por Conidiobolus lamprauges em ovinos.

An outbreak of conidiobolomycosis affecting sheep in the State of Santa Catarina, Southern Brazil is reported. The disease occurred in six Santa Inês breed sheep from a flock of 75 during the rainy season. Common clinical signs were noisy respiration and dyspnea, serous to mucosanguineous nasal discharge and exophthalmus. At necropsy there was a dense yellow mass in the nasopharyngeal area affecting the ethmoidal region, turbinate bones and occasionally limph nodes, central nervous system and pleura. Histopathologycally there was multifocal granulomas whith an eosinophilic necrotic reaction containing ribbon type hyphae similar to zygomycetous fungi. At molecular examination Conidiobolus lamprauges DNA was detected. The clinical, epidemiological, macroscopical, microscopical and molecular aspects characterize conidiobolomycosis caused by Conidiobolus lamprauges in sheep.

Capítulo 7 - Zigomicose / Chapter 7 - Zygomycosis

A zigomicose (mucormicose) é uma infecção rara, mas altamente invasiva, causada por fungos da ordem Mucorales (gêneros Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Saksenaea, Cunninghamella, Cokeromyces e Syncephalastrum). Esse tipo de infecção é usualmente associado a doenças hematológicas, cetoacidose diabética e transplante de órgãos. A apresentação clínica mais frequente é a mucormicose rinocerebral, com ou sem envolvimento pulmonar. A zigomicose pulmonar ocorre mais frequentemente em pacientes com neutropenia profunda e prolongada e pode se apresentar como infiltrado lobar ou segmentar, nódulos isolados, lesões cavitárias, hemorragia ou infarto. As manifestações clínicas e radiológicas são na maioria dos casos indistinguíveis daquelas associadas com aspergilose invasiva. Este artigo descreve as características gerais da zigomicose pulmonar, com ênfase no diagnóstico laboratorial, e ilustra a morfologia de algumas lesões.

Zygomycosis (mucormycosis) is a rare but highly invasive infection caused by fungi belonging to the order Mucorales, which includes the genera Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Saksenaea, Cunninghamella, Cokeromyces and Syncephalastrum. This type of infection is usually associated with hematologic diseases, diabetic ketoacidosis and organ transplantation. The most common form of presentation is rhinocerebral mucormycosis, with or without pulmonary involvement. Pulmonary zygomycosis is more common in patients with profound, prolonged neutropenia and can present as segmental or lobar infiltrates, isolated nodules, cavitary lesions, hemorrhage or infarction. The clinical and radiological manifestations are often indistinguishable from those associated with invasive aspergillosis. This article describes the general characteristics of pulmonary zygomycosis, emphasizing laboratory diagnosis, and illustrates the morphology of some lesions.

Zigomicosis cutánea primaria en paciente pediátrica inmunocomprometida / Primary zygomycosis in a pediatric inmunocompromised patient

La zigomicosis es una infección infrecuente causada por hongos oportunistas que pertenecen al orden Mucorales, cuya característica es la invasión vascular por hifas, lo que determina trombosis, infarto y necrosis tisular. En General afecta a pacientes con efermedades subyacentes, causando infecciones invasoras severas y a menudo fulminantes. Algunas condiciones de riesgo son: leucemias y linfomas con neutropenia prolongada, cetoacidosis diabética, malnutrición severa, ruptura de la integridad de la barrera cutánea y terapia inmunosupresora. Se presenta un caso de zigomicosis cutánea primaria en el antebrazo, en una paciente pedíatrica con leucemia linfobástica aguda de tipo B, con grave neutropenia y tratamiento con corticoides, y describimos los aspectos histológicos y clínicos de la lesión necrótica en la zona de punción venosa.

Meningoencefalitis zigomicótica piogranulomatosa en un puercoespín de cola pren sil (Coendou prehensilis) / Piogranulomatous zygomycotic meningoencephalitisb in a prehensile tailed porcupine (Coendou prehensilis)

Con el término de zigomicosis (ZM) se designa un grupo de enfermedades causadas por hongos de la clase Zygomicetes, de los órdenes Mucorales y Entomophthorales, de varios géneros y especies. La presentación de ZM en animales ocurre esporádicamente en numerosas especies tanto en animales domésticos como silvestres (incluso en mamíferos marinos) y son pocos los casos comprobados de aislamiento e identificación del agente causal. Pocos hongos son considerados como neurotrópicos ya que tienden a localizarse en el SNC después de invadir el hospedador; sin embargo, la mayoría de los casos de meningitis o meningoencefalomielitis son parte de micosis sistémicas como la Candidiasis, la Criptococosis, la Aspergilosis o la ZM. El presente trabajo documenta el hallazgo de una meningoencefalitis zigomicotica secundaria a un trauma craneoencefálico en un puercoespín de cola prensil (Coendou prehensilis), siendo una enfermedad rara infrecuente en el sistema nervioso central tanto en humanos como en animales y adicionalmente sin reportes previos en esta especie.

With the word Zygomycosis (ZM) are designating a group of diseases caused by fungi of the class Zygomicetes, the orders Mucorales and Entomophthorales, of several genera and species. The presentation of ZM in animals occurs sporadically in many species both in domestic and wild animals (including marine mammals), and are checked few cases of isolation and identification of the causative agent. Few fungi are considered to be neurotropic because they tend to be located in the CNS after invading the host; however, most cases of meningitis or meningoencephalomyelitis are part of systemic fungal infection such as Candidiasis, Cryptococcosis, Aspergillosis or ZM. This paper documents the discovery of a zigomicotic meningoencephalomyelitis secondary to a head trauma in a prehensile-tailed porcupine (Coendou prehensilis), being a rare disease infrequent in the central nervous system both in human and animals and additionally without previous reports in this specie.

Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis / Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante

A espondilite anquilosante (EA) pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30 por cento dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação rara. Um paciente com diagnóstico de EA desde 1998, com comprometimento axial, histórico de tuberculose pulmonar tratada em 2002 e 2007, evoluiu com um quadro de aspergilose bilateral em ápices pulmonares associada à zigomicose e Actinomyces spp. Havia sido internado para investigar queixa de emagrecimento, sudorese noturna, tosse produtiva e lesão nos ápices pulmonares. Foi submetido a tratamento cirúrgico de lobectomia de lobo pulmonar superior direito, após identificação de bola fúngica nos ápices pulmonares nas radiografias e tomografias, comprovados por exames de fibrobroncoscopia e biópsia com exame anatomopatológico. Evoluiu sem expansão pulmonar direita, foi submetido à nova fibrobroncoscopia que sugeriu oclusão do brônquio lobar médio. Uma nova toracotomia não confirmou o achado da fibrobroncoscopia. Permaneceu sem expansão pulmonar direita, evoluiu com choque séptico refratário ao tratamento e ao óbito.

Ankylosing spondylitis (AS) can be associated with extra-articular manifestations, among which we find pulmonary disorders. Fibrosis of the pulmonary apices is seen in up to 30 percent of the cases, and cyst formation is less common, being seen in advanced cases. Colonization of those cavities is a rare complication. A patient with a diagnosis of AS since 1998 with axial involvement and history of pulmonary tuberculosis treated in 2002 and 2007, developed bilateral aspergillosis of the pulmonary apices associated with zygomycosis and Actinomyces spp. The patient had been hospitalized to investigate complaints of weight loss, nocturnal diaphoresis, productive cough, and lesion in both lung apices. He was submitted to right upper pulmonary lobectomy after identification of a fungus ball on chest X-ray and CT scan, which was confirmed by a fibrobronchoscopy and biopsy for anatomopathological exam. The patient evolved without expansion of the right lung and underwent another fibrobronchoscopy that suggested occlusion of the middle lobar bronchus. Repeat thoracotomy did not confirm the findings of the last fibrobronchoscopy, but the right lung failed to expand. The patient developed septic shock refractory to treatment and died.

Lipid formation and gama-linolenic acid production by Mucor circinelloides and Rhizopus sp., grown on vegetable oil / Formação de lipídeos e produção de ácido gama-linolênico por Mucor circinelloides e Rhizopus sp., em óleos vegetais

The fungi strains were tested in Bioscreen automated system to select the best nutritional source. Following, shaking submserse cultures were studied in media containing sole carbon or nitrogen source. The growth of these strains improved in media containing vegetable oil, with high concentration of lipids. The high concentration of γ-linolenic acid was obtained with M. circinelloides in culture containing sesame oil.

Linhagens de fungos foram testadas em sistema automatizado Bioscreen para selecionar melhor fonte nutricional. Em seguida, foram estudadas culturas submersas em meios contendo uma única fonte de carbono e de nitrogênio. As linhagens contendo alta concentração de lipídeos tiveram melhor crescimento em meio contendo óleos de gergelim ou de dendê. Maior concentração de ácido γ-linolênico foi obtida com M. circinelloides nas culturas em óleo de gergelim.